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Frequency of Group A Streptococcus Infection and Analysis of Antibiotic Use in Patients with Pharyngitis-A
Martyna Biała1, Mateusz Babicki2, Wojciech Malchrzak2
1Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiences, Wroclaw Medical University, 51-149 Wroclaw, Poland.
Insights
Group A Streptococcus (GAS) pharyngitis occurred in 42.6% of patients, yet over half received antibiotics, indicating overuse. Strategies are needed to promote rational antibiotic use for sore throats.
Area of Science:
- Infectious Diseases
- Public Health
- Pharmacology
Background:
- Group A Streptococcus (GAS) causes significant pharyngitis in children and adults.
- Ineffective GAS treatment can lead to serious postinfectious complications.
- Optimizing antibiotic use for pharyngitis is crucial for patient outcomes and antimicrobial stewardship.
Purpose of the Study:
- To determine the frequency of GAS pharyngitis in primary care settings.
- To evaluate antibiotic prescribing patterns for patients diagnosed with pharyngitis.
- To identify potential areas for improving antibiotic management.
Main Methods:
- A multicenter, retrospective analysis of 1949 patient medical records from nine Polish primary care centers.
- Inclusion of patients diagnosed with pharyngitis, with data on rapid strep tests and antibiotic prescriptions.
- Analysis of GAS prevalence and antibiotic utilization based on diagnostic test results and patient demographics.
Main Results:
- GAS pharyngitis was diagnosed in 42.6% of patients via rapid strep test.
- Antibiotics were prescribed to 54.1% of all patients, including 224 with negative strep tests.
- Oral penicillin V and amoxicillin were the most frequently prescribed antibiotics.
Conclusions:
- The prevalence of GAS pharyngitis was substantial, but antibiotic prescription rates exceeded confirmed infections.
- Overprescription of antibiotics for pharyngitis was observed, highlighting a need for improved diagnostic stewardship.
- Development and implementation of strategies for rational antibiotic use in pharyngitis management are recommended.
Abstract:
Streptococcus pyogenes is responsible for 20-30% of pharyngitis in children and 5-15% in adults. The ineffective treatment of group A Streptococcus (GAS) infections can result in postinfectious sequelae. This study aims to evaluate the frequency of GAS pharyngitis and assess the management of patients with pharyngitis and antibiotic use. We conducted a multicenter, retrospective analysis of medical records from nine primary care centers in Poland. The study enrolled 1949 medical records of patients (children 67.4%, adults 32.6%). An infection of Streptococcus pyogenes, based on a rapid strep test, was diagnosed in 830 patients (42.6%). In the comprehensive study group of 1949 patients, 1054 (54.1%) were given antibiotics. Notably, 224 patients had a negative rapid strep test result but still received antibiotic treatment, underscoring the complexity of treatment decisions. The most commonly used antibiotics were oral penicillin V in 431 cases (41%) and amoxicillin in 219 cases (20.8%). We observed no significant difference between positive rapid strep test results and patients' sociodemographic data and comorbidities. The prevalence of GAS was 42.6% in the analyzed records of patients with pharyngitis, and 54.1% were prescribed antibiotics. Antibiotics were overprescribed for sore throats. Strategies are needed to promote rational antibiotic use.
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